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Please read and initial each statement, and sign at the bottom. This Attendant Care Contract (“Contract”) is made by Blue Skies Home Care LLC and the Attendant/Employee identified below (who will be employed by the Customer/Employer identified above) as of the Date of Contract specified below.
Full Name*
1*
I understand that the consumer I am working for is receiving Consumer Directed Services, which means the Consumer is my employer. The Consumer is responsible for the hiring, firing, training, and scheduling of me, the attendant.
2*
I understand I am not an employee of Blue Skies Home Care, LLC. I am an employee of the Consumer that I work for in their home. (When filling out loan applications or other financial paperwork, please do not indicate that Blue Skies Home Care, LLC, is your employer. The Consumer's name can be released in these circumstances, but you may not release any medical or personal information.)
3*
Blue Skies Home Care, LLC is the Fiscal Intermediary/Medicaid Enrolled Provider for Consumer Directed Services program. Blue Skies Home Care, LLC is responsible for providing oversight and ensuring the services provided by the attendant is in accordance with the Consumer’s Plan of Care authorized by the Department of Health and Senior Services (DHSS).
4*
I understand that I shall not work for Consumers while they are in the hospital, nursing home, or any type of inpatient stay.
5*
I understand I must always notify Blue Skies when I have a change of address or phone number.
6*
I understand that attendants shall only perform the approved tasks and hours as stated on the Care Plan. A copy of the current Plan of Care is in the Consumer's folder or available in the mobile app.
7*
I understand any hours that are worked over the authorized Care Plan will not be paid by Blue Skies Home Care, LLC.
8*
I understand that attendants may not work unless the consumer is in the home and awake. Consumers must be present and awake to supervise the attendant.
9*
I understand that while working for the consumer, the attendant must be performing care plan tasks at all times, and not sitting or visiting while clocked in.
10*
I understand attendants are NOT allowed to provide transportation to the hospital or the emergency room while they are on the clock. Attendants also MAY NOT provide transportation to medical appointments covered by Missouri Medicaid while working through the Consumer Directed Services Program. Consumers must contact MTM Medicaid Transportation for these appointments.
11*
I understand attendants are NOT allowed to provide transportation to recreational activities, such as going out to eat, visiting family or friends, church, going to the movies, etc. while working for the Consumer.
12*
I understand that if included on the Consumer's Plan of Care, attendants MAY provide transportation for essential errands. Essential errands would include grocery shopping, picking up prescriptions, going to the post office, etc. This is the Consumer’s decision. Attendants must have valid liability insurance when transporting Consumers in their vehicle. Blue Skies Home Care, LLC does not assume any liability for Consumers or attendants riding in each other's vehicles
13*
I understand that I may not provide pet care, lawn care, childcare, or assistance to anyone in the home other than the Consumer.
14*
I understand the following regarding Direct Deposit: Please never schedule auto payments previous to the Friday after the end of the pay cycle. Blue Skies Home Care will not pay any overdraft or late fees in any circumstances. Blue Skies Home Care is not liable for loss of money due to attendant negligence.
15*
I understand that I shall not provide paid personal care services to a Consumer who is my spouse. I understand that if I am married to a Consumer that I am working for, that this is a form of Medicaid Fraud.
16*
I understand that if I am not able to work my scheduled shift, I must notify the Consumer in advance, so the Consumer has adequate time to find a replacement worker. (This is especially important with Consumers who cannot transfer or use the toilet independently. Not being able to get out of bed is a health, safety and welfare issue and can be very detrimental to the Consumer's health.)
17*
I understand that I will not be paid by Blue Skies Home Care, LLC for any days that I work for the Consumer when the Consumer is not Medicaid eligible. It is the responsibility of the Consumer to track the Medicaid eligibility so I do not work on non-Medicaid eligible days.
18*
I understand that any of the following may delay my direct deposit: the use of a paper timesheet, not using EVV correctly, or submitting time worked in huge excess of the Consumer’s care plan.
19*
I understand that my paystub and W-2 can be accessed through the Attendant Portal at https://portal.bluesummit.io/auth/login. This can be accessed from the Mobile App by clicking on the Employee Portal Link.
20*
I understand that attendants and/or Consumers are solely responsible for any injuries or illness the Attendant sustains while providing personal care services to the Consumer. Neither Blue Skies Home Care, LLC nor the State of Missouri has any liability for such injuries or illness and are not required to provide workers compensation coverage to attendants.
21*
I understand that attendants accumulating over 40 hours of work per seven-day week will be compensated at the rate of time and one half for hours worked in excess of 40 hours. The time and one-half rate is based on the attendant’s current hourly wage. Hours worked in excess of 40 hours are subject to oversight by Blue Skies Home Care, LLC. Hours worked must be in compliance with the Consumer/employer’s plan of care as determined by the Department of Health and Senior Services.
22*
I understand that if I am working in excess of 40 hours per week, I must have prior approval from Blue Skies Home Care, LLC.
23*
I understand that if I am working for two or more Consumers with no break in service provision, I may bill for travel time from the home of one Consumer to the next Consumer using the Travel Report. The Travel Report is available from your CDS Specialist.
24*
I understand that if the Consumer I am working for has services with Blue Skies Home Care, LLC and another provider, that two attendants cannot work for the Consumer at the same time. This means the Consumer may have only one provider working in the home at any given time. If another attendant works at the same time as I do, I will report the multiple attendant circumstances to the Blue Skies Home Care’s CDS Specialist (case manager). Failure to do so may be considered fraud.
25*
I understand that if I am working for the Consumer through two or more providers, that I cannot bill the providers for the same hours. I must bill different hours when working for two or more providers. I must report all providers I am working for to the Blue Skies Home Care’s CDS Specialist. Failure to do so is considered fraud.
26*
I understand that if I have additional employment of any kind, I must report this to the Consumer’s CDS Specialist.
27*
I understand that as an attendant in the Consumer Direct Services program, it is my responsibility to report suspected abuse, neglect or exploitation to the Department of Health and Senior Services Adult Abuse and Neglect Hotline at 1-800-392-0210.
28*
29*
EVV is mandatory by state and federal regulations. I understand that I must use EVV for all shifts worked.
30*
I have been trained on how to complete a paper timesheet, if necessary, and understand that I must contact my Consumer’s CDS Specialist each time a paper timesheet is used. I further understand that failure to contact the CDS Specialist immediately, and failure to submit the timesheet immediately will result in non-payment for the visit(shift).
31*
I understand that claiming hours through EVV or on a paper timesheet that were not worked is considered to be Medicaid Fraud.
32*
I understand that I am the only person that can utilize my access code and password to clock in/out. No one can clock in or out for me. I further understand that if someone clocks me in or out, that this is considered to be Medicaid Fraud.
33*
I understand that anytime I am unable to utilize the EVV system due to a technical error, it is required to be reported ON THE DAY OF THE OCCURRENCE to the Consumer’s Blue Skies CDS Specialist. If the visit occurs after regular business hours, a voicemail must be left on the day it occurs.
34*
I understand that when EVV is unavailable, a paper timesheet is necessary to document the times worked. The attendant’s time-in should be recorded on the timesheet at the start of the work shift. The attendant’s time-out should be recorded on the timesheet at the end of the work shift. The timesheet must reflect the exact times worked, such as 1:53 PM to 3:35 PM. A phone call must be made to the CDS Specialist at the beginning and the end of the shift to document hours worked. Additionally, all blank timesheets must remain in the Consumer’s home.
35*
I understand that if I forget to clock out, I will not clock out when I remember because this will create a longer visit(shift) than what I actually worked. I understand that creating a visit longer than I actually worked is a form of Medicaid Fraud. I understand that the correct procedure is to cancel the visit, immediately contact Blue Skies Home Care, and complete a paper timesheet.
36*
I understand that if the Consumer's home phone is the required form of EVV to be used, I must utilize that phone to clock in and out for each shift worked.
37*
I understand that if the Consumer does not have a landline telephone and the app cannot be utilized, the attendant’s cell phone will be used to clock in and out. When a cell phone is the determined form of EVV to be used, a FOB will be placed in the Consumer’s home to be used in conjunction with the attendant’s cell phone.
38*
I understand that the FOB will be placed in the Consumer’s home by a Blue Skies Home Care, LLC, employee, and cannot be moved or removed by anyone other than a Blue Skies employee. Moving or removing the device will result in the attendant not being paid and the termination of the Consumer’s services with our company.
39*
I understand it is my responsibility to ensure my location is on at all times when I am using the mobile app.
40*
I understand I must be inside the Consumer’s home when clocking in and out, unless providing approved essential transportation specified on the Consumer’s care plan. I further understand that I will not be paid for any shifts in which my location does not indicate I am at the Consumer’s home when clocking in and out, unless it is for approved essential transportation.
41*
I understand that if essential transportation is provided, I MUST document this within the app. Documentation should state specifically what transportation was provided and where. I understand that I must contact my Consumer’s CDS Specialist immediately on the day in which it occurs if I am unable to document the reason within the app.
42*
I understand that when clocking in or out somewhere other than at the consumer’s home due to essential transportation, that I may not clock out on the road or at another location other than where the notes indicate the transportation was provided. For example, if the attendant notes that they are clocking in at the pharmacy, the GPS location should show a location of the pharmacy at the time of clock in. If the GPS location does not indicate this, the visit will not be paid.
43*
I understand it is my responsibility to check the history daily within the mobile app to ensure that all recent visits are accurate and up to date. If any visits are not accurate or there are any other issues, it is my responsibility to contact my Consumer’s CDS Specialist immediately.
44*
I understand that the Mobile App may only be downloaded on one device and that must be my primary cellular phone that I use on a daily basis. The App may not be downloaded on the consumer’s or anyone else’s phone or device. I also understand that if I get a new phone and need to download the App on that device, I must notify my Consumer’s CDS Specialist.
By initialing the above items and signing below, I indicate I understand these requirements. I understand that the Consumer Directed Service funds are from State and Federal revenues. Misuse of these funds may constitute fraud. I understand that all suspected fraud will be reported to the State Medicaid Fraud Unit and/or the local prosecutor as necessary and appropriate.
Signature of Attendant* Date*
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